# Implementation of Communication Disability Collection and Accommodations in Primary Care Settings

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2024 · $265,574

## Abstract

PROJECT SUMMARY/ABSTRACT
The Americans with Disability Act (ADA) requires that healthcare organizations and providers ensure that
patients with disabilities receive equal access to healthcare services, facilities and programs. While the ADA
was passed more than 30 years ago, research demonstrates that persons with disabilities continue to
experience significant health and healthcare disparities. Persons with communication disabilities, who
represent >14% of the US population, experience specific challenges to patient-centered communication, an
essential component of high-quality care as outlined by the National Academy of Medicine report “Crossing the
Quality Chasm”.
Documentation of patients’ demographic information (e.g., race/ethnicity, sexual orientation, and gender
identity) and social data (e.g., Social Determinants of Health) in electronic health records (EHR) has been
recognized by healthcare organizations, policy makers and advocates as a necessary step towards advancing
healthcare equity. Unfortunately, most healthcare organizations do not consistently or comprehensively
document patients’ disability status within the EHR. Consistent and accurate documentation of disability status
is needed to track the quality of care delivered to patients with communication disabilities and to identify
patients who need disability accommodations required by the ADA.
This project aims to adapt and evaluate the effects of an implementation support package of strategies to
assist primary care clinics in (1) documenting patients’ communication disability and accommodation needs in
the EHR and (2) providing communication disability accommodations. In Aim 1 we will employ Implementation
Mapping Adapt, which will allow us to review existing literature and build upon what is already known about
implementation of documentation of other demographic data. With a stakeholder panel, we will adapt an
implementation support package for documentation of communication disability status and provision of
communication accommodations in the primary care setting. Our final product will be a multi-component, multi-
level implementation support package designed for use in varying contexts. In Aim 2 and 3, we will conduct a
multi-method, Hybrid Type III effectiveness-implementation trial across 9 clinics in 3 healthcare systems:
UCHealth, Denver Health (a safety net health system), and Northwestern Medicine in Chicago, IL. The primary
care clinics will be diverse (e.g., urban, rural, women’s health, and geriatric clinics) to maximize learnings
across different contexts. Our outcomes will be guided by the PRISM/RE-AIM framework, with our primary
outcomes being the Reach of documentation of patients’ disability status (Aim 2) and the Adoption of provision
of disability accommodations (Aim 3.) The study findings will inform a support package with scalable strategies
that can be adapted and generalized to other types of disabilities.

## Key facts

- **NIH application ID:** 10873203
- **Project number:** 5R01DC020188-03
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Megan A Morris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $265,574
- **Award type:** 5
- **Project period:** 2022-09-16 → 2024-10-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873203

## Citation

> US National Institutes of Health, RePORTER application 10873203, Implementation of Communication Disability Collection and Accommodations in Primary Care Settings (5R01DC020188-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10873203. Licensed CC0.

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